Triple ultrasound markers including fetal cardiac activity are related to miscarriage risk

Objective: To identify early ultrasound markers in pregnant patients that predict a favorable pregnancy outcome. Design: Retrospective case-control study. Setting: Infertility patients in fertility clinic. Patient(s): 1051 women with early pregnancies conceived after fertility treatment. Intervention(s): None. Main Outcome Measure(s): Ongoing pregnancy >20 weeks' gestation. Result(s): Ongoing pregnancy rate was 90.5% for those pregnancies having early fetal cardiac activity (odds ratio [OR] = 66.5). Gestational sac diameter >= 12 mm was associated with ongoing pregnancy rate of 91.9%. Small gestational sac diameter, <8 mm, was associated with high miscarriage rate, 85.3%. Ongoing pregnancy rates for yolk sac diameter <2 mm, 2-6 mm, and >6 mm were 20%, 89.2%, and 20%, respectively (OR = 33.1, 2-6 vs <2 mm; OR 33.1, 2-6 vs >6 mm). Ongoing pregnancy rate was 94% when all three markers were present. Conclusion(s): On postconception days 33-36, gestational sac diameter >= 12 mm, yolk sac diameter 2-6 mm, and the presence of fetal cardiac activity were favorable markers. (Fertil Steril (R) 2011;96:1145-8. (C) 2011 by American Society for Reproductive Medicine.)